Low-Carbohydrate High-Protein Diet is Associated With Increased Risk of Incident Chronic Kidney Diseases Among Tehranian Adults

J Ren Nutr. 2019 Jul;29(4):343-349. doi: 10.1053/j.jrn.2018.10.007. Epub 2018 Dec 19.


Objective: The aim of this article was to assess the association between low-carbohydrate high-protein (LCHP) diet score and the risk of incident chronic kidney disease (CKD).

Design and methods: This cohort study was conducted on 1,797 Iranian participants, aged ≥20 years, followed-up for a mean of 6.1 years. Using a valid and reliable food-frequency questionnaire at baseline, LCHP diet score between 0 and 12 points were determined. Anthropometric measures and biochemical indicators were assessed. Participants were classified based on their estimated glomerular filtration rate (eGFR) levels using the National Kidney Foundation guidelines; eGFR ≥ 60 mL/minute/1.73 m2 as not having CKD and eGFR < 60 mL/minute/1.73 m2 as having CKD. Multivariable logistic regression was used to estimate the odds ratio for the occurrence of CKD according to the tertiles of LCHP diet score.

Results: Mean (standard) age of participants (48% male) was 37.7 (12.2) years at baseline. The median (25-75 interquartile range) of LCHP diet for all subjects was 7 (4-8), and incidence of CKD was 14.1%. After adjusting for age, sex, smoking status, physical activity, total calorie intake, body mass index, diabetes, hypertension, and baseline eGFR, participants in the highest tertile of LCHP diet had greater risk of incident CKD (odds ratio: 1.48; 95% confidence interval: 1.03-2.15), in comparison to those in the lowest one (P for trend = .027).

Conclusion: Our findings demonstrate the hypothesis that higher score of LCHP diet may have adverse effects on incidence and development of CKD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Causality
  • Cohort Studies
  • Diet, High-Protein Low-Carbohydrate / adverse effects*
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Incidence
  • Iran / epidemiology
  • Male
  • Prospective Studies
  • Renal Insufficiency, Chronic / epidemiology*
  • Risk Factors